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General NPI Number Information
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NPI Number | 1255957445
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Entity Type | Individual
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Provider Name | OLIVIA ANN MASON DDS
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Gender | Female
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Dates
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Enumeration Date | 06/23/2020
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Last Update Date | 06/29/2020
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Provider Practice Location Address
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Address Line | 1512 COMMERCE ST
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City | WELLSBURG
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State | WV
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Zip | 26070-1323
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Country | US
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Telephone | 304-238-8680
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Fax |
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Provider Business Mailing Address
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Address Line | 102 BORDER LN
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City | WHEELING
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State | WV
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Zip | 26003-7182
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Country | US
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Telephone | 304-238-8680
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4471
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License Number State | WV
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